IL-1 beta and TNF-alpha in prostatic secretions are indicators in the evaluation of men with chronic prostatitis

Purpose: Chronic Prostatitis, or Chronic Pelvic Pain Syndrome [CPPS], is a common disorder characterized by pelvic pain and varying degrees of inflamm ation in expressed prostatic secretions (EPS). In search of markers to more clearly define CPPS, we compared proinflammatory cytokines interleukin-1 b eta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) levels in EPS f rom men with CPPS, to healthy men and men with Benign Prostatic Hyperplasia (BPH). Methods: 78 men: controls (n = 16), BPH (n = 14), CPPS IIIA [greater than o r equal to 10 white blood cells per high power field (WBC/hpf) in EPS] (n = 18), CPPS IIIB [<10 WBC/hpf in EPS] (n = 20), and asymptomatic inflammator y prostatitis (AIP) (n = 10) were evaluated for EPS WBC, and IL-1 beta and TNF-alpha by ELISA. Results: IL-1 beta and TNF-alpha levels in EPS were usually detectable in m en with CPPS IIIA (89% and 45%, respectively) or AIP (90%; 100%), but less often in controls (31%; 17%), BPH(57%; 15%), and CPPS IIIB (35%; 15%) respe ctively. IL-1 beta and TNF-alpha levels were higher in CPPS IIIA versus CPP S IIIB, and in AIP versus controls or BPH (p's <0.001). Cut-points for IL-1 beta and TNF-alpha discriminated AIP from controls (predictive values = 94 % and 83%, respectively) and CPPS IILA from CPPS IIIB (predictive values 84 % and 100%). Overall, there was a correlation between IL-1 beta and TNF-alp ha (p <0.003), but no correlation between WBC and IL-1 beta (p <0.1) or TNF -alpha (p <0.50). Conclusions: Cytokines are frequently present and elevated in the EPS from men with CPPS IIIA and AIP and provide a novel means for identification, ch aracterization and potential management of men with CPPS that differs from traditional methods based on WBC.